Chapter 176B

Section 4M. The commissioner of insurance is hereby directed to produce a standardized claim form to be utilized by all health insurance companies licensed to do business in the commonwealth for billing purposes. Said form shall be made available to said companies no later than J…

Section 4MM. (a) A subscription certificate under an individual or group medical service agreement delivered, issued or renewed within the commonwealth shall develop a plan to provide adequate coverage and access to a broad spectrum of pain management services, including, but not…

Section 4N. Any subscription certificate under an individual or group medical service agreement that shall be delivered, issued or renewed in the commonwealth which provides coverage for prescription drugs, shall provide as benefits to all individual subscribers and members and t…

Section 4NN. (a) Any subscription certificate under an individual or group medical service agreement delivered, issued or renewed within the commonwealth shall provide coverage for: (i) tobacco use cessation counseling; and (ii) all generic United States Food and Drug Administrat…

Section 4O. Any subscription certificate under an individual or group medical service agreement that shall be delivered, issued or renewed in the commonwealth shall provide as a benefit for all individual subscribers or members within the commonwealth and all group members having…

Section 4OO. Any subscription certificate under an individual or group medical service agreement delivered, issued or renewed within the commonwealth shall provide coverage for treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections a…

Section 4P. Any subscription certificate under individual or group medical service agreement that shall be delivered, issued or renewed in the commonwealth which provides coverage for prescription drugs shall provide coverage for off-label uses of prescription drugs used in the t…

Section 4Q. Any subscription certificate under an individual or group medical service agreement that shall be delivered, issued or renewed in the commonwealth shall provide as a benefit for all individual subscribers or members within the commonwealth and all group members having…

Section 4QQ. A subscription certificate under an individual or group medical service agreement delivered, issued or renewed within the commonwealth that provides coverage for prescription eye drops shall provide coverage for refills of prescription eye drops in accordance with th…

Section 4R. (a) For the purposes of this section, the following words shall have the following meanings: ''Prosthesis'', an artificial appliance used to replace a lost natural structure; provided, however, that prosthesis shall include, but not be limited to, artificial arms, leg…

Section 4RR. (a) For the purposes of this section, ''psychiatric collaborative care model'' shall mean the evidence-based, integrated behavioral health service delivery method in which a primary care team consisting of a primary care provider and a care manager provides structure…

Section 4S. A subscription certificate under an individual or group medical service agreement which provides hospital expense and surgical expense insurance, except certificates which provide supplemental coverage to Medicare or other governmental programs, delivered, issued or r…

Section 4SS. For the purposes of this section, the following terms shall have the following meanings unless the context clearly requires otherwise: ''Community-based acute treatment'', 24–hour clinically managed mental health diversionary or step-down services for children and ad…

Section 4T. Any subscription certificate under an individual or group medical service agreement delivered, issued or renewed in the commonwealth shall provide as benefits to all individual subscribers and members within the commonwealth and to all group members having a principal…

Section 4TT. A subscription certificate under an individual or group medical service agreement that is issued or renewed shall provide benefits on a nondiscriminatory basis for medically necessary emergency services programs, as defined in section 1 of chapter 175.

Section 4U. (a) As used in this section, the following words shall have the following meanings:- ''Attending physician'', the emergency physician or consultant physician who actively treats the emergency medical condition of an insured at an emergency facility. ''Emergency medica…

Section 4UU. (a) For the purpose of this section, the following words shall have the following meanings: ''Licensed mental health professional,'' a licensed physician who specializes in the practice of psychiatry, a licensed psychologist, a licensed independent clinical social wo…

Section 4V. Any subscription certificate under an individual or group medical service agreement, except certificates providing supplemental coverage to Medicare or to other government programs, delivered, issued or renewed by agreement within or without the commonwealth shall pro…

Section 4VV. (a) For the purposes of this section, ''federally-defined preventive services'' shall mean: (i) evidence-based items or services that currently have a rating of ''A'' or ''B'' in the recommendations of the United States Preventive Services Task Force; (ii) immunizati…

Section 4W. (a) Any subscription certificate under an individual or group medical service agreement that is delivered, issued or renewed within or without the commonwealth and that provides benefits for outpatient services shall provide to all individual subscribers and members w…

Section 4WW. (a) For the purposes of this section, the following words shall have the following meanings unless the context clearly requires otherwise: ''Directly or indirectly cause impairment of fertility'', to cause circumstances where a disease or the necessary treatment for …

Section 4X. Any subscription certificate under an individual or group medical service agreement delivered, issued or renewed within the commonwealth shall provide for the coverage of patient care services furnished pursuant to qualified clinical trials as defined in, and subject …

Section 4XX. Any subscription certificate under an individual or group medical service agreement delivered, issued or renewed within the commonwealth, which is considered creditable coverage under section 1 of chapter 111M, shall provide coverage for postpartum depression and maj…

Section 4Y. Any subscription certificate under an individual or group medical service agreement which provides hospital expense and surgical expense insurance, delivered, issued or renewed by agreement between the insurer and the policyholder, within or without the commonwealth, …

Section 4YY. (a) Any subscription certificate under an individual or group medical service agreement delivered, issued or renewed within the commonwealth, which is considered creditable coverage under section 1 of chapter 111M, shall provide coverage for the provision of medicall…

Section 4ZZ. Any subscription certificate under an individual or group medical service agreement delivered, issued or renewed within the commonwealth shall provide coverage for universal postpartum home visiting services, in accordance with operational standards set by the depart…

Section 5. Any person residing in the commonwealth shall have the right to become a subscriber of a medical service corporation if his qualifications meet those specified in the by-laws of such corporation, provided that such a corporation may, in its discretion, refuse to issue …

Section 5A. No corporation subject to this chapter, and no officer or agent thereof, shall cancel, refuse to issue or renew, or in any way make or permit any distinction or discrimination in the amount or payment of premiums or rates charged, in the length of coverage, or in any …

Section 5B. For the purposes of this section the following words shall have the following meanings:— ''Genetic information'', a written recorded individually identifiable result of a genetic test as defined by this section or explanation of such a result. ''Genetic test'', a test…

Section 6. No subscription certificate shall be issued unless it contains in substance the following provisions: (a) A statement of the medical service to be paid for by the corporation, and if any medical service is excepted, a statement of such exception. (b) A statement of the…

Section 6A. Whenever a subscriber of a group non-profit medical service plan, other than the one authorized under the provisions of chapter thirty-two A or chapter thirty-two B, becomes ineligible for continued participation in such group plan because of involuntary lay-off or de…

Section 6B. (a) In the event of the granting of a judgment absolute of divorce or of separate support to which a subscriber of a group nonprofit medical service plan is a party, the person who was the spouse of said subscriber prior to the issuance of such judgment shall be and r…

Section 7. Every registered physician, chiropractor and nurse midwife shall have the right, on complying with such rules and regulations as the corporation may make, to enter into a written agreement with a medical service corporation, doing business in the city or town where the…

Section 7A. Any person who is eligible for Medicare coverage for both hospital and physician service due to age or disability, other than end-stage renal disease, shall be eligible for supplemental coverage to Medicare ninety days before and after the month of such person's Medic…

Section 7B. A medical service corporation governed by this chapter shall offer medicare supplemental group coverage to that group of medical assistance recipients designated from time to time by the department of public welfare. Such coverage shall be provided at a rate based on …

Section 7C. For purposes of this section, retroactive premium rate increase shall mean any premium rate increase based upon an actual approved rate which is assessed to a subscriber after any payment has been made by said subscriber based upon an estimated premium rate for such p…

Section 7D. (a) For the purposes of this section, the following words shall have the following meanings unless the context clearly requires otherwise: ''Behavioral health services'', as defined in section 1 of chapter 175, or ''services''. ''Provider'', (i) a mental health clinic…

Section 8. Every medical service corporation shall annually, on or before the first day of March, file in the office of the commissioner a statement, verified by at least two of the principal officers of said corporation, showing its condition as of the thirty-first day of Decemb…

Section 8A. In an account of its financial condition, a medical service corporation may include as an asset available for the payment of losses electronic data processing equipment, provided that the cost of such equipment at the time of acquisition is at least one hundred thousa…

Section 8B. Notwithstanding any general or special law to the contrary, chapter 176V shall apply to a medical service corporation governed by this chapter.

Section 8C. Notwithstanding any general or special law to the contrary, chapter 176W shall apply to a medical service corporation governed by this chapter.

Section 9. The commissioner, or any deputy examiner or any other person designated by the commissioner, shall, at least once in three years, and whenever the commissioner deems it prudent, visit any medical service corporation and examine into its affairs. The commissioner shall …